超声定位下经皮肾镜治疗肾结石(附73例报告)  

Treatment of renal calculi with percutaneous nephrolithotomy under ultrasonic guidance: A report of 73 cases

作　　者：卢剑[1] 肖春雷[1] 马潞林[1] 庄申榕[1] 刘余庆[1] 田晓军[1] 张荣新[1] 

机构地区：[1]北京大学第三医院泌尿外科,北京100083

出　　处：《中国微创外科杂志》2007年第6期532-533,共2页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的：探讨超声定位下经皮肾镜下治疗肾结石结石的有效性与安全性。方法：2005年1月～2006年11月在超声定位下经皮肾镜应用气压弹道或钬激光治疗肾结石73例，肾盏穿刺单通道或多通道取石，其中单发肾结石46例，多发肾结石27例；单肾结石67例，双肾结石6例；肾铸形结石ll例。结果：57例一期取石成功，13例二期取石，3例三期取石。单通道取石53例，双通道取石18例，三通道取石2例。微造瘘通道47例，标准肾造瘘通道26例。手术时间50～160min，平均86min。结石取净率93．2％（68／73），5例残留结石均〈0．6cm。术后出血3例，输血2例，术后发热3例。48例术后随访3～6个月，平均4个月，未见结石复发。结论：超声定位下经皮肾镜治疗肾结石具有简便、安全的特点，是一种微创高效的方法。Objective To evaluate the efficacy and safety of percutaneous nephrolithotomy under ultrasonic guidance for the treatment of renal calculi, Methods Percutaneous nephrolithotomy using pneumatic or holmium laser lithotripsy under ultrasonic guidance was performed in 26 patients from January 2005 to November 2006. Among them, 46 patients had single stones and 27 had multiple renal calculi. Unilateral renal calculi were found in 67 patients and bilateral calculi in 6, Staghorn calculi were identified in 11 patients, Results Of the 73 patients, a successful stone removal on one session was achieved in 57 patients, a second-look stone removal was needed in 13 patients, and 3 patients underwent three times of operation, During the operation, a single tract was used in 53 patients, double tracts in 18 patients, and three tracts in 2. A mini-invasive tract （F14 - F18） was used in 47 patients, and a standard tract （F24） was established in the remaining 26 patients. The operation time was 50～ 160 min （mean, 86 min）, The stonefree rate was 96.2% （68/73） , and the residual stones in other 5 patients were all 〈 O, 6 cm in size. Postoperative bleeding was found in 3 patients, and 2 of them were given a blood transfusion. Postoperative pyrexia occurred in 3 patients, Follow-up examinations in 48 patients for 3～6 months （mean, 4 months） found no stone recurrence. nephrolithotomy under ultrasonic guidance is simple and safe, being a calculi. Conclusions Treatment of renal calculi with percutaneous kind of effective and minimally invasive technique for renal

关 键 词：超声 经皮肾镜 肾结石 

分 类 号：R692.4[医药卫生—泌尿科学]